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2) Autism Toilet Training: A step-by-step guide to removing nappies.

Toilet training any child feels challenging for parents. Toilet training autistic children can take longer, start later and may have extra challenges. Over the years, we have helped a lot of parents do this successfully. In the second part of this autism toilet training series, we’ll share the step-by-step guide to removing nappies. If you haven’t already read our guide on building the foundations for toilet training success, you can find our best tips here.

Toilet training autistic children: Before you start

  1. Choose a day to start toilet training. Plan to spend at least the next three days at home fully focused on your child. Ideally, keep up to seven days free. Remember, once you take nappies off for toilet training, you will only put them back on for bedtime! Avoid planning any trips out or car journeys where you’ll be tempted to put a nappy back on.
  2. Before starting, make sure you have followed the strategies we recommend to build the foundations for toilet training.
  3. Prepare your child for the upcoming change in whichever ways they respond best (e.g., verbally, with a social story, using a visual schedule, or with their speech device).

Step-by-step guide

  1. When your child wakes up, remove their nappy and take them to sit on the toilet or potty. Model how to ask for the toilet either verbally, with signs, with PECS or using the talker.
  2. Have them sit for 3-5 minutes.
  3. If you manage to catch a wee or poo in the toilet, great! Help them clean up and follow the handwashing steps. Consider following a successful movement in the toilet with something positive to help your child learn this is the goal.
  4. If not, that’s ok. Follow the rest of the steps anyway and be careful not to put pressure on them.
  5. Set your timer for 30 minutes and spend time playing with your child. Keep a close eye on them for any signs they might have an accident. Keeping them in a top and pair of underwear will make this easier to spot.
  6. If your child starts to have an accident, help them get to the toilet and finish on the toilet. Use a calm tone of voice, gestures and facial expression to avoid creating any anxiety or worries. You can say something neutral like “Wee goes in the toilet”. Reset your timer from the point of the accident.
  7. If your child does not have an accident, take them to the toilet when the 30 minutes is over and repeat step 1.

Changing the toileting schedule

Once your child has a day with no accidents (or with very few), try increasing to taking them to the toilet every 40 minutes. As they master this schedule, keep increasing the schedule by 10 minutes at a time.

If you get stuck at any point or aren’t having success, try reducing the schedule by ten minutes and giving them longer to master.

Once you reach 60 minutes, resuming normal life becomes a lot easier!

Once you reach around 90 minutes, you may find you start to remind your child to use the toilet at natural transition points (e.g., before going out) rather than sticking to a schedule. Whenever it feels right, start to do this and try to give your child opportunities to initiate toilet visits themselves by prompting a little less.

1) Autism Toilet Training: Expert Tips for a Smooth Journey

Toilet training any child can be daunting. When that child has autism, toilet training can take longer, start later and may have extra challenges. Over the years, we have helped a lot of parents with strategies for toilet training autistic children. In this autism toilet training series, we’ll share what we’ve learned to help you have a smoother journey. Let’s start with some strategies you can use to set your child up to succeed before you take nappies off. Resist the temptation to rush through these – spending a few weeks on these strategies can make the toilet training process easier and less stressful.

Autism toilet training: image of a toilet roll

Autism toilet training: deciding when to start.

We recommend planning a week where your child is at home with you or another caregiver. The summer holidays can be a great time as not only are children off school, but the warmer weather means your child can comfortably play in a t-shirt and pants. This reduces the number of steps to get them onto a potty or toilet quickly.

Ideally, plan to start working on these tips at least a few weeks before the week of toilet training.

Making the process familiar.

When your child follows you into the bathroom, you can follow the same steps each time and talk through the process (simplifying language if needed). Look for stories or create a booklet that describes the steps of using the toilet. If your child enjoys imaginary play, act out the steps of using the toilet with their characters and toys.

Consider creating a social story, or a visual schedule that talks through the steps of using the toilet. When you use the bathroom, or when acting the steps out with toys, follow the same sequence.

Autism toilet training equipment.

If you’re trying to decide if you should start toilet training with a potty or move straight to an adapted toilet seat you’re not alone. Consider whether your child struggles with changes to established routines. If they do, they might do better starting with the adapted toilet seat so that there is one less change for them. If transitions are harder for them and you don’t have a toilet on every floor, a potty can be more convenient as they won’t have to go so far to get to the toilet.

Look for a toilet seat or toilet seat and step combo that will leave your child’s feet supported. This will help them feel more stable and secure.

Make sure your child can reach the bathroom sink and soap – they may also need a step to do this.

Building confidence on the toilet

Give your child the chance to explore the potty or toilet. Create time in your routine where you spend a little time in the bathroom every day with the ultimate goal of practising sitting* on the potty or toilet each day.

* We recommend teaching both boys and girls to sit on the potty or toilet initially.

  • Ideally, have your child sit on the potty/toilet at the same point in your routine or rhythm every day. This will be easier for you to remember and predictable for your autistic child who thrives on routines
  • Add something your child will look forward to – perhaps they love bubbles or a certain song. My daughter loves to see videos of her family so we asked the family to send videos of what they’d been doing and we watched these.
  • If your child seems nervous to sit, resist the temptation to push them and give them lots of time to get used to the potty/toilet seat.
    • Let them enjoy doing something next to it until they become more comfortable
    •  Aim to gently encourage without adding lots of pressure.

Next: 2) Autism Toilet Training: A step-by-step guide to removing nappies.

How to play with kids with autism – 7 simple changes to make to your play style

Play is such an important part of learning, socialising and spending time as a child and is at the heart of our approach to teaching the kids we work with. However, children with autism often have delays in their language, social and play skills which means their play can look a little different. Adults who want to play with autistic kids can sometimes find it trickier because of this. 

Here are some simple strategies that parents and professionals can incorporate into their play with autistic kids.

While these strategies are simple, it’s worth noting that you might have to change some of your habits and behaviours. This can be tricky to begin with, but with practice, they will become second nature.

Why is it worth changing how I play?

By changing how you play with autistic kids, you can become not only a more fun and engaging partner, but you can also teach a child new ways to play and communicate and create space for them to initiate more social interactions.

 Moving away from heavily adult-led play 

Because it can be harder to catch the attention of autistic kids, and because their play skills might be delayed, parents and staff can easily end up playing in a very heavily adult-led way. It can be tempting to call the child’s name and use lots of instructions and questions to try to get their attention and capture their interest. It’s awesome to be motivated to play with your child and to be enthusiastic about encouraging new play ideas. However, the problem with this particular play style is that the adult can accidentally become a demanding play partner.

Let’s look at a made-up example of an interaction between a parent and a child playing with some Duplo:

“Look, Kevin! I’m building a house! Kevin, look! Do you want to build a house? Put the brick here Kevin. Pass me the big green brick and we’ll put it here. Wow, do you like it? Put the red brick here.”

In the imaginary example above, the adult calls the child’s name three times, provides five instructions (remember that “Look” is an instruction) and asks two questions. All in the space of less than ten seconds! This is quite a lot to process all at once and the child is likely to struggle and may therefore become disengaged with the game.

Skills Autistic Kids Find Harder

Let’s pause and think about some of the skills children with autism often find harder:

  • Responding to name
  • Following instructions
  • Processing information
  • Answering questions
  • Processing social interactions
  • Looking at others
  • Following another person’s reference (gaze, point etc.)

Now that we’ve been through that list, it can help us to understand why the above example could be quite difficult for Kevin.

Adding in lots of things that a child finds difficult (instructions, questions, looking, responding to name) makes the play become hard work and less fun. Furthermore, this leaves no time or space for the child to initiate an interaction with their play partner.

Suggestions for how to play with autistic kids

We’ve identified what doesn’t work well, so let’s look at what does. 

1) Follow their interests:

First, find a play activity that your child enjoys. This can be any type of play (e.g. messy play, cause and effect play, imaginary play), join in with them and copy what they are doing.

2)  Add something

Next, take what your child is already doing and try adding something. If they’re chopping some sand, perhaps you can sprinkle it from really high. If they’re pushing a car, try driving it under your legs as if they’re a tunnel.

3) Comment on what you’re doing

Instead of making demands and asking questions, try to switch to making comments about what you’re doing without placing any expectation on your child to respond. While this can be a very difficult habit to change, it’s very important to try.

There are lots of ways of adding comments to your play.  Instead of “Look Kevin! I’m building a house,” try, “Wow, I’ve made a house.” You can comment on actions (“It’s falling/spinning”), you can add sound effects (car noises, animal noises, snoring noises for characters) and you can build anticipation with countdowns (“1,2,3…” or “Ready, steady, go!”) Remember to match your language to your child’s ability levels – they might need shorter sentences or fewer words (“Fell down!”) or they might be fine with longer sentences (“Oh no, the man fell off the bridge!”) If your child is already making comments, try copying what they’re saying and adding something to reinforce and expand on this. E.g. “Oh no!” “Oh no, it fell down!”

4) Sound like you’re having a good time

A great way of catching your autistic child’s interest in your actions is simply to sound like you’re having fun. If your tone of voice and comments are enthusiastic, they may catch your child’s attention in a low-pressure way.

5) Leave gaps in your play to allow your child opportunities to take the lead.

You can give your child opportunities to communicate or to contribute to the play in their own way without placing pressure on them. Usually, this is just a case of making a comment or modelling a play action, then pausing to see if your child responds. Remember that children on the autism spectrum sometimes need a bit of extra time to process things, so if you move the play along too quickly, they might not have time to join in.

6) Let things go

If you try modelling a fun play action or comment, and your child doesn’t look or seem interested, that’s ok! Instead of convincing them to pay attention, remember that you can try again later. Maybe they are distracted right now, maybe they’re not interested right now or maybe they’re just not that into what you’re trying out.

7) Keep an eye on interest during play

Autistic kids might struggle to tell you what they like and don’t like. This means you might need to watch what they’re showing you instead. Are they moving or turning away? This might mean they’re not so keen on what you’re doing right now. Are they turning towards you, smiling, laughing, moving closer or copying what you say or do? Great! Those are signs that they’re enjoying what you’re doing. 

Remember to keep following interests. If your child moves away from an activity, respect that and allow them to take a break. Alternatively, if your child shows an interest in something else, follow their lead and play together with that thing instead of staying with their current interests. Continue to follow the 7 suggestions as you go from one play activity to the next

Help! My autistic child has a meltdown whenever their Grandparents visit.

A question families often ask us, is “Why does my autistic child become so upset whenever their Grandparents visit?”. The child may have a meltdown, cry when Grandma/Grandad arrives, refuse to let them in or try to push them back out the door! This can be stressful for everyone involved.

Why does this happen?

One reason why this may happen is that many parents rely on Grandparents to help out with childcare – this means that a visit from a Grandparent becomes associated with Mum/Dad leaving. This association with a  parent leaving can be hard for the relationship between your child and their grandparents. For children with language delays, this may be the only way they know how to tell you that they don’t want Mum/Dad to leave. Other children may struggle with a lack of predictability in their day. To them, the grandparents visiting could mean that Mum/Dad might leave or might stay – this uncertainty can be stressful for some children.

Continue reading “Help! My autistic child has a meltdown whenever their Grandparents visit.”

Encouraging Joint Attention in Children with Autism

Children learn so much by looking at our faces.  At first they look because they enjoy our faces.  Later, they look to see what we are looking at and what we think.  This is called joint attention and provides an important foundation for language learning. 

A child who is noticing where we are looking when we say a new word, will know what the word refers to.  For children who are not looking as much, such as children with autism spectrum disorders, there are games that encourage them to enjoy and learn from looking. 

Continue reading “Encouraging Joint Attention in Children with Autism”
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